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New Insights on Pharmacologic and Non-Pharmacologic Therapy of Advanced Heart Failure

A special issue of Journal of Clinical Medicine (ISSN 2077-0383). This special issue belongs to the section "Cardiology".

Deadline for manuscript submissions: 5 February 2027 | Viewed by 768

Special Issue Editor


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Guest Editor
German Ctr Heart & Circulatory Res DZHK Partner Site Berlin, Berlin, Germany
Interests: ventricular function; heart failure; mechanical circulatory support; heart transplantation; echocardiography; cardiac physiology; cardiac immunology; right ventricle; pulmonary hypertension
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Special Issue Information

Dear Colleagues,

Despite the important progress in the improvement of treatment strategies for patients with advanced heart failure (AHF), the incidence of cardiac decompensation episodes still remains very high and is further closely associated with worse prognosis, as well as with a poor quality of life for the affected persons.

This Special Issue aims to highlight new opportunities for early identification of patients at high risk for AHA and their optimal treatment in order to prevent the development of AHA, the further improvement of medical and device-related treatments for AHA, including the use of mechanical circulatory support systems, the optimal timing of heart transplantation (HTx) for eligible patients and the therapy of HTx candidates included on the waiting list, as well as the use of the most optimal immunosuppression and other necessary therapies for heart-transplant recipients, including the therapy of cardiac allograft rejections.  

Dr. Michael Dandel
Guest Editor

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Keywords

  • advanced heart failure (AHF)
  • mechanical circulatory support systems
  • heart transplantation (HTx)
  • immunosuppression
  • cardiac allograft rejections

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Published Papers (1 paper)

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Research

12 pages, 1093 KB  
Article
Residential Environmental Composition and Risk of Acute Cellular Rejection After Heart Transplantation: A Multi-Scale Buffer Analysis
by Tomasz Urbanowicz, Krzysztof Skotak, Dominika Konecka-Mrówka, Rafał Skowronek, Jakub Bratkowski, Jerzy Nożyński, Julia Gierszewska, Jarosław Bartkowski, Hanna Wachowiak-Baszyńska, Piotr Przybyłowski and Marek Jemielity
J. Clin. Med. 2026, 15(9), 3272; https://doi.org/10.3390/jcm15093272 - 24 Apr 2026
Viewed by 461
Abstract
Background: Acute cellular rejection (ACR) after heart transplantation remains incompletely explained despite standardized immunosuppression. Environmental exposures may contribute to residual immune activation; however, prior studies have focused primarily on air pollution rather than residential land-use composition. Objectives: To determine whether buffer-specific residential environmental [...] Read more.
Background: Acute cellular rejection (ACR) after heart transplantation remains incompletely explained despite standardized immunosuppression. Environmental exposures may contribute to residual immune activation; however, prior studies have focused primarily on air pollution rather than residential land-use composition. Objectives: To determine whether buffer-specific residential environmental composition is associated with rejection risk and whether these associations are scale-dependent and domain-specific. Methods: In this retrospective single-center cohort study, 30 heart transplant recipients contributed 267 biopsy-linked observations. Residential land-use composition was quantified within 300 m, 500 m, 700 m, and 1000 m buffers and aggregated into five domains: trees, other green surroundings, roads, water, and industrial land. Associations with ACR were evaluated using clustered logistic regression models adjusted for time since transplantation. Results: The strongest and only statistically robust associations after FDR correction were observed within the 300 m buffer. Tree-dominant (OR 1.42, 95% CI 1.22–1.65, q = 0.010) and industrial land exposure (OR 1.50, 95% CI 1.28–1.76, q = 0.010) were independently associated with increased odds of ACR. At 500 m, the association with trees persisted nominally (OR 1.39, 95% CI 1.03–1.88, p = 0.034), but did not remain significant after FDR correction, whereas water exposure showed a non-significant trend (OR 1.28, p = 0.057), which did not reach statistical significance. No associations were observed beyond 700 m across all models. Conclusions: Residential environmental composition may be associated with acute cellular rejection after heart transplantation in a scale-dependent manner, with signals confined to the immediate residential environment. Tree-dominant exposure within 300 m showed an association in clustered models; however, this finding was attenuated in mixed-effects sensitivity analyses. These results should be considered exploratory and hypothesis-generating study. Full article
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